中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (09): 488-490.doi: 10.3969/j.issn.1671-4091.2016.09.011

• 临床研究 • 上一篇    下一篇

血液滤过治疗中应用析因设计分析TNF-a筛选系数的影响因素

叶家骏,许卓谦,肖彬,姚淑雯,郑国营,李东华   

  1. 南方医科大学附属花都医院重症医学科
  • 收稿日期:2016-01-08 修回日期:2016-08-05 出版日期:2016-09-12 发布日期:2016-09-12
  • 通讯作者: 许卓谦 zhqxu@126.com E-mail:zhqxu@126.com
  • 基金资助:

    广东省医学科学技术研究基金面上项目, 项目编号：WSTJJ20140120440121197309271214

The factors to influence TNF-α sieving coefficient in continuous veno-venous hemofiltration analyzed by factorial design

  • Received:2016-01-08 Revised:2016-08-05 Online:2016-09-12 Published:2016-09-12

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摘要： 目的通过析因设计探讨血液滤过中肿瘤坏死因子α(tumor necrosis factor-α,TNF-a)筛选系数的影响因素。方法48 例严重脓毒症患者随机分为8 组，每组6 人行连续性静脉静脉血液滤过(continuous veno venous hemofiltration,CVVH)治疗，将CVVH 的超滤速度[30ml/(kg·h)、70ml/(kg·h)]、血浆流量(100ml/min,180ml/min)和治疗时间(6h,12h)作为影响因素，按2×2×2 析因设计分为8 组，评介其对TNF-a 筛选系数的影响。结果超滤速度、治疗时间对TNF-a 筛选系数有交互作用(P=0.001), 在超滤速度为30ml/h、治疗时间为6h 的组中TNF-a 筛选系数最高(0.162±0.002)；超滤速度30ml/(kg·h)与70ml/(kg·h)相比、治疗时间6h 与12h 相比，TNF-a 筛选系数增加(P＜0.001)；血浆流量100ml/min 与180ml/min 相比,TNF-a 筛选系数下降(P＜0.001)。结论超滤速度、治疗时间对TNF-a筛选系数有交互作用；增加超滤速度和延长治疗时间，TNF-a 筛选系数下降；增加血浆流量可提高TNF-a筛选系数。

关键词: 血液滤过, 析因设计, TNF-a筛选系数

Abstract: Objective To investigate the factors to influence tumor necrosis factor α (TNF-α) sieving coefficient in continuous veno-venous hemofiltration (CVVH) analyzed by factorial design. Method A total of 48 patients with severe sepsis were randomly divided into 8 groups (6 patients in each group). CVVH ultrafiltration rate was set at 30ml/(kg· h) or 70ml/(kg· h), plasma flow at 100ml/min or 180ml/min, and treatment time at 6h or 12h. The patients were then divided into 8 groups according to the 2×2×2 factorial design to evaluate the impacts of the three factors on TNF-α sieving coefficient. Results Ultrafiltration rate and treatment time had interacted effect on TNF-α sieving coefficient (P=0.001). TNF-α sieving coefficient was the highest in the group with ultrafiltration rate of 30ml/h and treatment time of 6h (0.162±0.002). TNF-α sieving coefficient increased in ultrafiltration rate of 30ml/kg.h as compared to that of 70ml/(kg· h), and in treatment time of 6h as compared to that of 12h (P＜0.001). TNF-α sieving coefficient decreased in plasma flow of 100ml/min as compared to that of 180ml/min (P 0.001). Conclusion Ultrafiltration rate and treatment time have interacted effect on TNF-α sieving coefficient. TNF-α sieving coefficient becomes decreased when ultrafiltration rate increases and treatment time is prolonged. TNF-α sieving coefficient becomes increased when plasma flow rises.

Key words: Hemofiltration, Factorial design, TNF-a sieving coefficient